'Death with Dignity' on the Massachusetts Ballot

A group called Death with Dignity is collecting signatures for a ballot proposal that would make Massachusetts the fourth U.S. state, following Washington, Oregon, and Montana, to legalize assisted suicide.

The Boston Globe published a balanced cover story about the subject in its Sunday Magazine last weekend -- what Rush might call a random act of journalism.  Reporter Scott Helman points out that despite its secular culture, "New England has proved to be inhospitable territory for efforts to legalize assisted suicide."  A ballot initiative in Maine failed in 2000, and efforts have stalled in the legislatures of Vermont, Massachusetts, and New Hampshire.  Although Massachusetts is a "socially progressive, prominent East Coast state," nearly half of the population is Catholic, and church leaders and many prominent physicians have begun a campaign to defeat the ballot proposal.

The Globe article summarizes arguments against "physician assisted dying" (as its supporters call it): "A number of [opponents] object on moral grounds, believing suicide is wrong and doctors should never abet it; others fear that the sick will be misdiagnosed and end their lives prematurely."

Doctors point out that "terminally ill patients are often depressed, and their mental state impairs their thinking. Instead of sanctioning their desire for suicide, opponents say, we should help them."

Furthermore, "the push for assisted suicide ignores advances in palliative care, or treatment to make patients as comfortable and pain-free as possible as they battle their illness."

The Massachusetts proposal attempts to mitigate coercion by doctors, health insurance companies, and family members, but this will always be a concern when the state dispenses the power to end life.

One of the Death with Dignity organizers, Heather Clish, was inspired by the assisted suicide of her father Lee Fronk Johnson, who was diagnosed with terminal brain cancer similar to Ted Kennedy's.  Kennedy was diagnosed in June 2008 and died fourteen months later in August 2009.  He underwent chemotherapy and brain surgery, and he remained in the Senate until June 2009.  The Independent Payment Advisory Board might have judged this a waste of medical resources, but I admire the way Kennedy clung to life.

Johnson, on the other hand, returned to his home state of Oregon and was prescribed a lethal dose of barbiturates, ending his life four and a half months after his diagnosis.  Perhaps Johnson's cancer progressed more rapidly than Kennedy's.  But according to the account in the Globe, Lee Johnson did not appear to be a man at the end of his rope.  "His condition was rapidly worsening," we read.  "He had fallen. His mobility was increasingly limited."  The article continues:

His wife took him for a last Heath Bar Blizzard at Dairy Queen. They arranged for hospice care. [...] The family gathered. They shared memories and traded jokes. "He was like, 'Hey, isn't anybody going to at least bring some flowers in here?' " Clish says. "So we got some flowers." Clish pulled up US Geological Survey maps on her laptop to make sure she understood exactly in which Utah canyon he wanted his ashes spread. They played Emmylou Harris, one of his favorite artists. They served him toasted Haystack Bread, from a Cannon Beach bakery, topped with his wife's homemade raspberry jam. Around 8:30 that night, after everyone had said their goodbyes, he drank the Seconal solution from one of his favorite Scotch glasses.

 The story is meant to be a heart-warming example of a good death.  I find it chilling.

This man still loved life, still took pleasure in flowers, his favorite foods, favorite music, favorite Scotch glass.  He joked around with his family and clearly loved them.  His mobility might have been limited, but he was still going out to Dairy Queen.  He had fallen -- once?  He savored his wife's homemade raspberry jam.  If you have ever picked raspberries to make jam, you know it is a labor of love.

Lee Johnson's family simulated the ritual of the condemned man's last meal, which is offered on the one hand as a final kindness and on the other hand to say, We are depriving you of these sensual pleasures of life because of the crimes you have committed.  Enjoy your last meal, but know that it is your last.

But Heather Clish's father was not condemned to die on the day he did.  Nothing was stopping him from having Haystack Bread toast with his wife's raspberry jam the next morning and the morning after, and five Heath Bar Blizzards a day, if he chose.  He might not have lived another fourteen months like Senator Kennedy, but he certainly had a day, a week, a month, six months left.

Why, then, did he end his precious life prematurely?  Why did his family surround him and support his decision?

The Globe article suggests an answer: "Johnson said he cherished the power to pick the time and place of his death. 'It is,' he wrote, 'simply the last choice I can make for myself...I have been an independent person since I was 13 years old.'"

As with abortion, the language around assisted suicide devolves to "choice."  Was no one there in Lee Johnson's final hour to urge him to choose life?  I'm not saying he should have spent his last days desperately seeking every medical treatment possible.  If the chance for successful cancer treatment is in single digits, it is entirely rational to choose six months at home with one's family as opposed to a year enduring surgery and chemotherapy.

Heather Clish believes that her father died with dignity -- meaning, I suppose, that he didn't suffer the indignity of things like adult diapers and feeding tubes.  Lee Johnson may have been exemplary in life, and since I have never experienced long-term illness or chronic pain, I am reluctant to judge decisions made by people who have given up the struggle to live.  Many of us have seen someone we love die, and the final weeks and months can be agonizing.  But, with apologies to his grieving family, I don't find Johnson's final decision commendable.  Choosing the hour of our death is above our pay grade; cherishing the power to be as gods is evidence not of dignity, but of hubris and lack of humility.  We were given life by no power of our own, and it is disrespectful to this great miracle to think we have the right to end it at our own choosing.

I will be voting against the death with dignity initiative.

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